Medicare Medicaid Category

Medicare & Medicaid

News articles in this section include actions by federal regulators like the CMS and HHS, as well as information on Medicare and state Medicaid coverage and benefits.

Medi-Cal Under Threat: Who’s Covered and What Could Be Cut?

Medi-Cal, California’s complex, $174.6 billion Medicaid program, provides health insurance for nearly 15 million residents with low incomes and disabilities. The state enrolls twice as many people as New York and more than three times as many as Texas.

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CMS May Soon Propose Medicaid Provider Tax Regulation

The Centers for Medicare & Medicaid Services (CMS) submitted a regulation to the Office of Management and Budget (OMB) that could upend Medicaid provider tax program financing. The regulation is titled “Preserving Medicaid Funding for Vulnerable Populations—Closing a Health Care-Related Tax Loophole.” “This proposed rule would update existing regulations that govern the process for states ...

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When Hospitals Ditch Medicare Advantage Plans, Thousands of Members Get To Leave, Too

For several years, Fred Neary had been seeing five doctors at the Baylor Scott & White Health system, whose 52 hospitals serve central and northern Texas, including Neary’s home in Dallas. But in October, his Humana Medicare Advantage plan — an alternative to government-run Medicare — warned that Baylor and the insurer were fighting over ...

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Once All-Powerful, Pharma’s Allies In Washington Are Fleeting

Big Pharma isn’t sure how to handle Donald Trump’s Republican Party. Trump is pledging to impose tariffs on drug imports, while Health Secretary Robert F. Kennedy Jr. has vilified the drug industry’s profits and questioned the safety of its products. Long a lobbying powerhouse in Washington, pharma’s struggling to settle on a strategy for defending ...

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Trump Order Seeks Changes To Medicare Drug Price Negotiation Program, PBM Reform

The wide-ranging order requires the Department of Health and Human Services to seek public comment on the drug price negotiation program, which effectively requires manufacturers to agree to lower prices for certain drugs, for potential changes in upcoming years.

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CMS To End Federal Match For States’ Medicaid Funding Requests

The Centers for Medicare and Medicaid Services (CMS) will restrict federal funds for state-based programs that go toward certain priorities like rural broadband and student loan repayments. The department is looking to return to the “core mission of Medicaid” by rejecting, or not extending, federal matching fund requests for designated state health programs (DSHPs) and ...

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Health Insurance Stocks Soar After Boost To Medicare Reimbursement Rates

Shares of U.S. health insurers jumped on Tuesday after a bigger-than-expected increase in the government’s reimbursement rates for Medicare Advantage plans in 2026 signaled some relief for a sector burdened with steep medical costs. Medicare-focused insurer Humana (HUM.N), opens new tab led gains with a 16% jump, while other health insurers including UnitedHealth Group (UNH.N), opens new tab, ...

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California OKs $2.8B To Close Medicaid Funding Gap After Expanding Immigrant Coverage

California Gov. Gavin Newsom signed legislation Monday to close a $2.8 billion budget gap in the state’s Medicaid services and ensure coverage through June for 15 million people, including immigrants, who receive health care via the program. The legislation is part of the state’s solution to solve the $6.2 billion hole in the state’s Medicaid budget. It ...

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CMS Finalizes 5.06% Medicare Advantage Benchmark Increase

The Centers for Medicare & Medicaid Services (CMS) finalized an increase of the average benchmark payments to Medicare Advantage (MA) plans by 5.06%, or $25 billion, on Monday. It is nearly a three-percentage-point increase over the advance notice proposed in the waning days of the Biden administration and will be seen as favorable to payers. ...

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Medicare Advantage Final Rule Excludes Anti-Obesity Drug Coverage Under Medicare, Medicaid

The Centers for Medicare & Medicaid Services (CMS) finalized a Medicare Advantage (MA) rule proposed by the Biden administration but is choosing to leave out the rule’s flashiest policy. As outlined by the CMS, the Trump administration’s final rule will not include three proposals included in the initial proposal, including the plan to cover anti-obesity ...

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